Data Conversion Services - ELLKAY EMR Clinical Data Output Specification

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ELLKAY, LLC 2011

EMR OUTPUT CSV SPECIFICATION
Version History
Changes to our documentation will be summarized below. The current document’s version can be found
in the footer on the left hand side of every page.
1.0.0 • First release of ELLKAY’s EMR CSV specification.
v. 1.0.0 CONFIDENTIAL
EMRConversion@ELLKAY.com Page 2
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Table of Contents
Version History.............................................................................................................................................. 2
Table of Contents .......................................................................................................................................... 3
PhysicianMaster ............................................................................................................................................ 4
1. InsuranceMaster ................................................................................................................................... 4
2. PatientDemographics............................................................................................................................ 5
3. PatientEncounters................................................................................................................................. 8
4. Appointments ....................................................................................................................................... 9
5. Allergies................................................................................................................................................. 9
6. PatientDiagnosis ................................................................................................................................... 9
7. FamilyHistory ...................................................................................................................................... 10
8. Immunization ...................................................................................................................................... 10
9. MedicationHistory .............................................................................................................................. 11
10. Multimedia ...................................................................................................................................... 11
11. Notes ............................................................................................................................................... 12
12. PastMedicalHistory ......................................................................................................................... 12
13. ProblemList ..................................................................................................................................... 12
14. SocialHistory.................................................................................................................................... 13
15. SurgicalHistory ................................................................................................................................ 13
16. Vitals................................................................................................................................................ 13
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PhysicianMaster
Column Name Description Notes/Comments
1 PhysicianCode Physician’s Code PK *
2 LastName Physician’s Last Name *
3 FirstName Physician’s First Name *
4 Address Physician’s Address
5 Address2 Physician’s Address
6 City Physician’s City
7 State Physician’s State
8 ZipCode Physician’s Zip Code
9 CountryCode Physician’s County Code
10 Phone Physician’s Phone
11 Fax Physician’s Fax
12 Email Physician’s Email
13 DEA Physician’s DEA
14 Degree Physician’s Degree
15 PhysicianUPIN Physician’s UPIN
16 MedicalStateLicense Physician’s Medical State Licence
17 NPI Physician’s NPI
18 Specialty Physician’s Specialty
1. InsuranceMaster
1 InsCode Insurance Code PK
2 InsName Insurance Name *
3 InsName2 Insurance Name 2
4 InsAddress1 Insurance Address 1
5 InsAddress2 Insurance Address 2
6 InsCity Insurance City
7 InsState Insurance State
8 InsZip Insurance Zip
9 InsPhone Insurance Phone
10 InsContact Insurance Contact
11 InstType Insurance Type
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2. PatientDemographics
1 ChartNo Patient Chart No. PK *
2 MRN MRN
3 AlternateID Alternate ID
4 Status Status
5 Department Department
6 PATFullName Patient Full Name
7 PATPrefix Patient Prefix
8 PATlastname Patient Last Name
9 PATFirstName Patient First Name
10 PATMiddleInit Patient Middle Initial
11 PATSuffix Patient Suffix
12 PATAddress1 Patient Address 1
13 PATAddress2 Patient Address 2
14 PATCity Patient City
15 PATState Patient State
16 PATZip Patient Zip
17 PATHomePhone Patient Home Phone
18 PATWorkPhone Patient Work Phone
19 PATCellPhone Patient Cell Phone
20 PATFax Patient Fax
21 PATPager Patient Pager
22 PATEmail Patient Email
23 PATSSN Patient Social Security Number
24 PATDOB Patient Date of Birth YYYYMMDD
25 PATSex Patient Sex Please see valid Sex values below
26 PATOccupation Patient Occupation
27 Please see valid Marital Status
PATMarital Patient Marital Status below
28 PATRace Patient Race Please see valid Race values below
29 PATBloodType Patient Blood Type
30 PATEmergencyContact Patient Emergency Contact
31 PATEmergencyPhone Patient Emergency Phone
32 PATComments Patient comments
33 GuarantorID Guarantor’s ID
34 GuarFullName Guarantor’s Full Name
35 GuarPrefix Guarantor’s Prefix
36 GuarLastname Guarantor’s Last Name
37 GuarFirstname Guarantor’s First Name
38 GuarMiddleInit Guarantor’s Middle Initial
39 GuarSuffix Guarantor’s Suffix
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40 GuarAddress1 Guarantor’s Address 1

41 GuarAddress2 Guarantor’s Address 2
42 GuarCity Guarantor’s City
43 GuarState Guarantor’s State
44 GuarZip Guarantor’s Zip
45 GuarHomePhone Guarantor’s Home Phone
46 GuarWorkPhone Guarantor’s Work Phone
47 GuarDOB Guarantor’s Date of Birth
48 GuarSex Guarantor’s Sex
49 GuarSSN Guarantor’s Social Security Number
50 GuarMartial Guarantor’s Martial Status
51 GuarRace Guarantor’s Race
52 GuarRelationship Guarantor’s Relationship
53 EmployerName Employer’s Name
54 EmpAddress1 Employer’s Address 1
55 EmpAddress2 Employer’s Address 2
56 EmpCity Employer’s City
57 EmpState Employer’s State
58 EmpZip Employer’s Zip
59 EmpPhone Employer’s Phone
60 Empfax Employer’s Fax
61 FK (PhysicianMaster) * - may be
blank if data is not available from
PhysicianCode Physician’s Code source system
62 FullName Physician’s Full Name
63 LastName Physician’s Last Name
64 FirstName Physician’s First Name
65 MiddleInit Physician’s Middle Initial
66 UPIN Physician’s UPIN
67 License Physician’s License
68 NPI Physician’s NPI
69 DateModified Record Date Modified
70 PriInsCode Primary Insurance Code
71 PriInsName Primary Insurance Name
72 PriInsAddress1 Primary Insurance Address 1
73 PriInsAddress2 Primary Insurance Address 2
74 PriInscity Primary Insurance City
75 PriInsState Primary Insurance State
76 PriInsZip Primary Insurance Zip
77 PriInsPhone Primary Insurance Phone
78 PriInsFax Primary Insurance Fax
79 PriPolicyNo Primary Policy No.
80 PriGroupNo Primary Group No.
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81 PriGroupName Primary Group Name

82 Primary Insurance Relationship To
PriRela2Hld Holder
83 PriStartDt Primary Insurance Start Date
84 PriEndDt Primary Insurance End Date
85 PriFullname Primary Insurer’s Full Name
86 PriLastName Primary Insurer’s Last Name
87 PriFirstName Primary Insurer’s First Name
88 PriMiddleInit Primary Insurer Middle Initial
89 PriAddres1 Primary Insurer’s Address 1
90 PriAddress2 Primary Insurer’s Address 2
91 PriCity Primary Insurer’s City
92 PriState Primary Insurer’s State
93 PriZip Primary Insurer’s Zip
94 PrihomePhone Primary Insurer’s Home Phone
95 PriWorkPhone Primary Insurer’s Work Phone
96 PriDOB Primary Insurer’s Date of Birth
97 PriSex Primary Insurer’s Sex
98 Primary Insurer’s Social Security
PriSSN Number
99 PriEmployer Primary Insurer’s Employer
100 PriEmployerID Primary Insurer’s Employer ID
101 Primary Insurer’s Employer Address
PriEmpAddress1 1
102 Primary Insurer’s Employer Address
PriEmpAddress2 2
103 PriEmpCity Primary Insurer’s Employer City
104 PriEmpState Primary Insurer’s Employer State
105 PriEmpZip Primary Insurer’s Employer Zip
106 PriEmpPhone Primary Insurer’s Employer Phone
107 PriEmpfax Primary Insurer’s Employer Fax
108 SecInsCode Secondary Insurance Code
109 SecInsName Secondary Insurance Name
110 SecInsAddress1 Secondary Insurance Address 1
111 SecInsAddress2 Secondary Insurance Address 2
112 SecInscity Secondary Insurance City
113 SecInsState Secondary Insurance State
114 SecInsZip Secondary Insurance Zip
115 SecInsPhone Secondary Insurance Phone
116 SecInsFax Secondary Insurance Fax
117 SecPolicyNo Secondary Insurance Policy No
118 SecGroupNo Secondary Insurance Group No
119 SecGroupName Secondary Insurance Group Name
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120 Secondary Insurance Relationship

SecRela2Hld to Holder
121 SecStartDt Secondary Insurance Start Date
122 SecEndDt Secondary Insurance End Date
123 SecFullname Secondary Insurer’s Full Name
124 SecLastName Secondary Insurer’s Last Name
125 SecFirstName Secondary Insurer’s First Name
126 SecMiddleInit Secondary Insurer’s Middle Initial
127 SecAddress1 Secondary Insurer’s Address 1
128 SecAddress2 Secondary Insurer’s Address 2
129 SecCity Secondary Insurer’s City
130 SecState Secondary Insurer’s State
131 SecZip Secondary Insurer’s Zip
132 SechomePhone Secondary Insurer’s Home Phone
133 SecWorkPhone Secondary Insurer’s Work Phone
134 SecDOB Secondary Insurer’s Date of Birth
135 SecSex Secondary Insurer’s Sex
136 Secondary Insurer’s Social Security
SecSSN Number
137 SecEmployer Secondary Insurer’s Employer
138 SecEmployerID Secondary Insurer’s Employer ID
139 Secondary Insurer’s Employer’s
SecEmpAddress1 Address 1
SecEmpAddress2 Address
141 SecEmpCity Secondary Insurer’s Employer’s City
SecEmpState State
143 SecEmpZip Secondary Insurer’s Employer’s Zip
SecEmpPhone Phone
145 SecEmpfax Secondary Insurer’s Employer’s Fax
3. PatientEncounters
1 ChartNo Patient Chart No. FK (PatientDemographics) *
2 EncounterID Encounter ID PK *
3 EncounterDate Encounter Date
4 EncounterTitle Encounter Title
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4. Appointments
1 ChartNo Patient’s Chart No. FK (PatientDemographics) *
2 EncounterID Encounter ID FK (PatientEncounters) *
PhysicianCode Physician’s Code source system
4 AppDate Appointment Date
5 AppTime Appointment Time
6 AppType Appointment Type
7 ApptDuration Appointment Duration
8 ApptLocationCode Appointment Location Code
9 ApptLocation Appointment Location
10 AppDept Appointment Department
11 AppNotes Appointment Notes
5. Allergies
1 ChartNo Patient Chart No FK (PatientDemographics) *
2 EncounterID Patient Encounter ID FK (PatientEncounters) *
PhysicianCode Physician Code source system
4 AllergyType Allergy Type
5 Allergen Allergen
6 Reaction Reaction
7 Severity Severity
8 Admits Admits
9 AllergyStartDt Allergy Start Date
10 comments Comments
6. PatientDiagnosis
3 DiagnosisCode Diagnosis Code
4 Description Description
5 ResolvedDate Resolved Date
6 Result Result
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7 ResolvedBy Resolved By
8 Comments Comments
7. FamilyHistory
4 Disorder Disorder
5 FamilyMembers Family Members
6 Admits Admits
7 Comments Comments
8. Immunization
4 Immunization Immunization
5 ImmunizationDate Immunization Date
6 Time Immunization Time
7 ImmunizationCode Immunization Code
8 LotNo Immunization Lot No.
9 Site Immunization Site
10 Route Immunization Route
11 Dose Immunization Dose
12 Strength Immunization Strength
13 Unit Immunization unit
14 Manufacturer Immunization Manufacturer
15 DateOfExpiry Immunization Date of Expiry
16 DueDate Immunization Due Date
17 CPTCode Immunization CTP Code
18 Status Immunization Status
19 Comments Immunization Comments
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9. MedicationHistory
4 Medication Medication
5 Dosage Dosage
6 Direction Direction
7 StartDate Medication Start Date
8 StopDate Medication Stop Date
9 StopReason Stop Reason
10 Active Active Flag
11 Chronic Chronic
12 Effective Effective
13 Contraceptive Contraceptive
14 DoseAction Dose Instruction
15 DoseQuantity Dose Quantity
16 DoseUnit Dose Unit
17 DoseRoute Dose Route
18 DoseTiming Dose Timing
19 DoseNotes Dose Notes
20 Dispense Dispense
21 Dispenseunit Dispense Unit
22 Refills Refills
23 Allowgeneric Generic Flag
24 Comments Comments
10. Multimedia
2 DateCreated Record Creation /Scanned Date
3 Category Category
4 Title Title
5 FilePath File Path
6 FileName File Name
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11. Notes
3 Title Note Title
4 Completed Completed
5 Filepath File Path
6 FileName File Name
12. PastMedicalHistory
4 PMHCondition PMH Condition
5 Details Details
6 0:Denies
Admits Admits 1:Admits
7 Comments Comments
13. ProblemList
4 Code Code
5 Problem Problem
6 Result Result
7 ResolvedBy Resolved By
8 ResolvedDate Resolved Date
9 Comments Comments
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14. SocialHistory
4 SocialItem Social Item
5 Details Details
6 Admits Admit
7 Comments Comments
15. SurgicalHistory
4 SurgeryDate Surgery Date
5 Surgery Surgery
6 Complications Complicatons
7 Comments Comments
16. Vitals
4 BP_StandingSys Blood Pressure Standing Systolic
5 BP_StandingDia Blood Pressure Standing Diastolic
6 BP_SittingSys Blood Pressure Sitting Systolic
7 BP_SittingDia Blood Pressure Sitting Diastolic
8 BP_SupineSys Blood Pressure Supine Systolic
9 BP_SupineDia Blood Pressure Supine Diastolic
10 Temperature Temperature Fahrenheit (98.6)
11 HeartRate Heart Rate
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12 Weight Weight Pound and ounces (150,12)

13 Height Height Feet’ inch’’ (5,9)
14 Resp Resp
15 OFC Head Cirumference
16 Comments Comments
Key:
*: Mandatory
PK: Primary Key
FK: Foreign Key
Marital Status:
S Single
D Divorced
M Married
W Widow/Widower
O Other
Relationships:
S SELF
SP SPOUSE
C CHILD
D DEPENDENT
E EMPLOYEE
W WIFE
H HUSBAND
P PARENT
O OTHER
Race:
White
Black
Asian
Indian/Alask
Pac Isle
Other/Mult
Sex:
M Male
F Female
O Other

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Data Conversion Services - ELLKAY EMR Clinical Data Output Specification

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1|Page

ELLKAY, LLC 2011

1.0.0 • First release of ELLKAY’s EMR CSV specification.

40 GuarAddress1 Guarantor’s Address 1

81 PriGroupName Primary Group Name

120 Secondary Insurance Relationship

12 Weight Weight Pound and ounces (150,12)

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